Organization
UNIVERSITY DIAGNOSTICS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY R NEWSOM M.D. (OWNER)
(205) 553-9171
Entity
Organization
Contact information
Practice address
701 UNIVERSITY BLVD E STE 204, TUSCALOOSA, AL 35401-7431
(205) 553-9171
(205) 553-9127
Mailing address
701 UNIVERSITY BLVD E STE 204, TUSCALOOSA, AL 35401-7431
(205) 553-9171
(205) 553-9127
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
21330
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051558457
BLUE CROSS BLUE SHIELD
—
Enumeration date
01/30/2007
Last updated
11/05/2008
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